| Sequential retroperitoneal venous hemorrhage and embolism of an angio-seal puncture closure device complicating iliac artery angioplasty. | |
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MedLine Citation:
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PMID: 10495155 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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PURPOSE: To present a case of iatrogenic puncture closure device embolization complicating surgery for retroperitoneal hemorrhage (RPH) secondary to angioplasty-induced common iliac vein trauma. METHODS AND RESULTS: A 78-year-old woman with rest pain underwent successful kissing balloon dilation of her aortoiliac bifurcation for a calcified ostial stenosis of the left common iliac artery. Hemostatic puncture closure devices (Angio-Seal) were used to secure both femoral punctures. A right-sided retroperitoneal hematoma developed, and during surgical exploration of the right groin, the Angio-Seal device was removed. The only bleeding site found was the external iliac artery puncture and it was repaired. She again became hypovolemic 18 hours later and was returned to surgery, where bilateral groin explorations and laparotomy by the vascular surgical team found a tear in the left common iliac vein. After repair, the patient was stable for 48 hours when the left leg became critically ischemic. Angiography detected a new high-grade stenosis in the left profunda femoris artery; embolectomy retrieved a footplate from the left puncture closure device. The patient died 11 days later from multiorgan failure. CONCLUSIONS: RPH should be considered early as an occult cause of hypovolemic shock developing soon after even technically straightforward iliac angioplasty. Interventionists should be aware that using the Angio-Seal device risks acute limb ischemia if footplate embolization occurs. |
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Authors:
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M A Tomlinson; R Beese; M Banwell; T Loosemore; T M Buckenham; J A Dormandy |
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Publication Detail:
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Type: Case Reports; Journal Article |
Journal Detail:
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Title: Journal of endovascular surgery : the official journal of the International Society for Endovascular Surgery Volume: 6 ISSN: 1074-6218 ISO Abbreviation: J Endovasc Surg Publication Date: 1999 Aug |
Date Detail:
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Created Date: 1999-11-02 Completed Date: 1999-11-02 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 9500580 Medline TA: J Endovasc Surg Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 264-9 Citation Subset: IM |
Affiliation:
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Department of Vascular Surgery, St. George's Hospital, London, United Kingdom. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Angiography, Digital Subtraction Angioplasty, Balloon / adverse effects* Arterial Occlusive Diseases / radiography, therapy Embolism / etiology*, radiography, surgery Equipment Failure Fatal Outcome Female Femoral Artery Hematoma / etiology*, radiography, surgery Hemostasis, Surgical / instrumentation* Humans Iliac Artery Iliac Vein / injuries*, radiography Laparotomy Punctures* Retroperitoneal Space |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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